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Am J Psychiatry 1994; 151:1437-1447
Copyright © 1994 by American Psychiatric Association
Absence of regional hemispheric volume asymmetries in first-episode schizophrenia
RM Bilder, H Wu, B Bogerts, G Degreef, M Ashtari, JM Alvir, PJ Snyder and JA Lieberman
Department of Psychiatry, Hillside Hospital Division of Long Island Jewish Medical Center, NY 11004.
OBJECTIVE: The goal of this study was to determine whether patients
experiencing their first episode of schizophrenia differ from healthy
subjects in regional cerebral hemispheric volumes or asymmetries. METHOD:
Regional volumes corresponding to prefrontal, premotor, sensorimotor,
occipitoparietal, and temporal lobes in each hemisphere were measured on
contiguous coronal magnetic resonance images in 70 patients experiencing
their first episode of schizophrenia and in 51 healthy comparison subjects.
RESULTS: Patients did not differ from the comparison subjects in regional
or total hemispheric volumes, but they had abnormal hemispheric
asymmetries. Subjects in the comparison group had significant lateral
asymmetries in each region: their occipitoparietal and sensorimotor regions
were larger on the left, and their premotor, prefrontal, and temporal
regions were larger on the right. Patients lacked lateral asymmetries and
showed significantly less asymmetry than healthy subjects in
occipitoparietal, premotor, and prefrontal regions. Absence of the normal
asymmetry was more common among patients initially diagnosed with the
undifferentiated than with the paranoid subtype of schizophrenia and was
associated with more severe negative symptoms among men. Asymmetries were
related to sex and handedness regardless of diagnosis; specifically,
dextral men showed more asymmetry than nondextral men or dextral women.
CONCLUSIONS: The absence of normal hemispheric asymmetries suggests an
anomaly in the development of laterally specialized cerebral systems in
schizophrenia, and this may be associated with an initial presentation of
nonparanoid psychosis.
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